功能磁共振对脑梗死后出血性转化的预测

目的探讨功能磁共振在脑梗死患者出血性转化中的预测价值。方法对44例脑梗死患者进行队列研究。所有患者均进行弥散加权成像（diffusion-weighted imaging,DWI）及灌注加权成像（perfusion-weighted imaging,PWI）检查。患者根据有无溶栓分为溶栓组20例,非溶栓组24例;根据有无出血性转化（hemorrhagic transformation,HT）分为HT组13例,非HT组31例。比较各自临床及功能磁共振上的特点。结果 44例患者中,发生HT的患者共13例,占29.5%。其中溶栓组发生HT 8例,占40%。保守治疗组发生HT 5例,占20.8%。溶栓组PWI上相对局部脑血容量值（relative regional cerebral blood volume,rrCBV）较非溶栓组降低,差异有统计学意义（P=0.037）。HT组入院时血糖、DWI上病灶体积、最低ADC值异与非HT组差异有统计学意义。结论脑梗死后HT是一个常见的并发症,溶栓治疗后发生率增加,功能磁共振可以预测溶栓后HT。

Prediction of hemorrhagic transformation after cerebral infarction by functional magnetic resonance imaging

Objective To investigate the predictive value of functional magnetic resonance imaging in patients with hemorrhagic transformation after cerebral infarction.Methods A cohort study was completed with 44 cases of cerebral infarction patients.All patients underwent diffusion-weighted imaging(DWI) and perfusion-weighted imaging(PWI) examination.The patients were divided into two groups(thrombolysis group of 20 patients,non-thrombolysis group of 24 patients) according to whether thrombolytic was used.According to whether occurred hemorrhagic transformation(HT),the patients were divided into HT group of 13 cases and non-HT group of 31 cases.The features of clinical and functional magnetic resonance imaging were compared between different groups.Results In 44 patients,13 cases occurred in HT,accounting for 29.5%.8 cases in thrombolytic group occurred in HT,accounting for 40%.5 cases in conservative treatment group occurred in HT,accounting for 20.8%.The relative regional cerebral blood volume(rrCBV) of thrombolysis group on PWI were statistically lower than that of non-thrombolysis group(P = 0.037).Compared with non-HT group,the level of blood glucose was statistically higher in HT group on admission,lesion volume on DWI was larger and low ADC value was significantly lower statistically.Conclusion Hemorrhagic transformation is a common complication in cerebral infarction,the risk increased after thrombolytic therapy.Functional magnetic resonance imaging can be helpful to predict HT in patients who received thrombolytic therapy.